Concordance with Prevention Guidelines and Subsequent Cancer, Cardiovascular Disease, and Mortality: A Longitudinal Study of Older Adults

Heather Greenlee, Garrett Strizich, Gina S. Lovasi, Robert C. Kaplan, Mary L. Biggs, Christopher I. Li, John Richardson, Gregory L. Burke, Annette L. Fitzpatrick, Amanda M. Fretts, Bruce M. Psaty, Linda P. Fried

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Reports on the associations between multiple clinical and behavioral health indicators and major health outcomes among older adults are scarce. We prospectively examined concordance with guidelines from the American Cancer Society and American Heart Association for disease prevention in relation to cancer, cardiovascular disease (CVD), and mortality among Cardiovascular Health Study enrollees aged 65-98 years who, at baseline assessment in 1989-1996 (n = 3,491), were free of CVD and cancer. Total and cause-specific mortality, as well as incidence of cancer and CVD, were lower with higher guideline concordance. Independent of body mass index, blood pressure, total cholesterol, and fasting plasma glucose, better health behaviors (diet, physical activity, and alcohol consumption) were associated with lower mortality (2-sided P < 0.0001). Among individuals with ideal levels for 3-4 of these 4 cardiometabolic biomarkers, those with poor concordance with health behavior recommendations had higher mortality compared with those who had the highest concordance with these behavioral recommendations (adjusted mortality hazard ratio = 1.82, 95% confidence interval: 1.25, 2.67). Older adults who are concordant with recommendations for cancer and CVD prevention have reduced rates of chronic disease and mortality. Interventions to achieve and maintain healthy lifestyle behaviors may offer benefits both in the presence and absence of adverse traditional clinical risk factors.

Original languageEnglish (US)
Pages (from-to)1168-1179
Number of pages12
JournalAmerican Journal of Epidemiology
Volume186
Issue number10
DOIs
StatePublished - Nov 15 2017

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Keywords

  • cancer
  • cardiovascular disease
  • epidemiology
  • health promotion
  • prevention

ASJC Scopus subject areas

  • Epidemiology

Cite this

Greenlee, H., Strizich, G., Lovasi, G. S., Kaplan, R. C., Biggs, M. L., Li, C. I., Richardson, J., Burke, G. L., Fitzpatrick, A. L., Fretts, A. M., Psaty, B. M., & Fried, L. P. (2017). Concordance with Prevention Guidelines and Subsequent Cancer, Cardiovascular Disease, and Mortality: A Longitudinal Study of Older Adults. American Journal of Epidemiology, 186(10), 1168-1179. https://doi.org/10.1093/aje/kwx150